Fasting during Ramadan – lasting from 15th October to 12th November this year – is one of the five pillars of Islam. The experience of fasting is intended to teach Muslims self-discipline and self-restraint, and to help them understand a little of the plight of the less privileged. But what are the implications of fasting for patients with type 2 diabetes?
It's something that we do so often, but are we always doing it the best way? Check out how to measure blood pressure (BP) correctly, with latest advice from the National Institute for Clinical Excellence and the British Hypertension Society.
This article considers a possible scenario in primary care in which a patient presents with chest pain. Test yourself to see what you would do. Then check this against our recommendations, reflecting on your current procedures and policies within your practice.
Sleep apnoea is far more than just snoring associated with brief periods of suspended breathing while asleep. It is an important risk factor for cardiovascular disease and diabetes, so it is well worth asking patients whether they suffer breathing problems during the night and then following up those who do. More than one-third of people with sleep apnoea have hypertension, so measuring blood pressure is important in assessing risk factors and then establishing appropriate preventive treatment.
Atrial fibrillation (AF) is one of those terms that we are hearing more and more in general practice. It is an important risk factor for stroke – particularly in older people – making it a good candidate for primary care teams to target in efforts to prevent cardiovascular disease.
Angina is a common problem in primary care, affecting around one in every six patients aged 65 years and over. It is predominantly chest pain due to transient myocardial ischaemia caused by coronary artery disease. Episodes of angina are typically caused by exertion or emotion, and are relieved by rest. Treatment with drugs and/or surgery that improves blood flow to the heart and lifestyle changes can significantly improve patients' quality of life and survival.
Thromboembolism is a common complication of heart disease – particularly in patients with atrial fibrillation (AF). Decisions to prescribe an anticoagulant are based on assessment of an individual patient's risk of clotting and the side-effects of treatment. With growing numbers of patients with heart disease, the number of patients on anticoagulants is increasing and there is a shift to primary care-based anticoagulation clinics. Practice nurses have a central role in educating patients about anticoagulation therapy and in monitoring their ongoing care.